Observation Billing Guidance

Date: 10/30/23

Heritage Health (Medicaid):

Effective February 1, 2024, the Nebraska Total Care Medicaid plan is aligning to CMS Medicare Claims Processing Manual Chapter 4 (PDF) - Part B Hospital / 290.5.3 - Billing and Payment for Observation Services direction from this source that the number of units reported with HCPCS code G0378 must equal or exceed 8 hours.

If you have questions, please contact Provider Relations.